What is AMH and why does IVF depend on it?

AMH, or anti-Müllerian hormone, is more interesting than its name suggests. It’s a revealing little protein associated with the reproductive system – and an AMH test can help IVF patients evaluate their chances of success.

AMH is secreted by cells in a woman’s growing follicles. (Men produce a little AMH too.) Testing plasma levels of AMH before IVF is a useful indicator of ovarian reserve and potential response to IVF drugs. If AMH levels are within the normal range, your ovaries may react better to stimulating medication. Overly low or high levels aren’t so good.

But who needs AMH when you’ve got FSH? The answer is that, while AMH testing has yet to be internationally accepted as a key blood-hormone test before IVF, it’s only a matter of time. An AMH test looks at the growth of small follicles. Growing follicles tell us a lot about reserve follicles waiting in the wings. FSH whips these into shape and does a sterling job. But AMH levels give a snapshot of ovarian supply and the test is a more accurate marker of female fertility and reproductive lifespan. Think of FSH as a reliable old Ford and AMH as a cutting-edge Aston Martin.

AMH levels drop off as you get older. Visible and microscopic follicles decrease. By the menopause, AMH levels and follicle count are negligible. Since it’s often women in their late thirties and early forties who have IVF with their own eggs, an AMH assessment of primary follical growth is a very good idea.

It was originally thought that an AMH test couldn’t tell you about the quality of your follicles. This has been refuted in recent research (see below). What’s more understood is that AMH levels highlight follicle quantity. Generally, low AMH means there’s not enough petrol (i.e. eggs) in the tank. Sadly, you can’t buy any more.

Worldwide reference ranges vary, as they do for LH, prolactin and TSH. But unlike those hormones, AMH levels don’t tail off or increase in your cycle: you can take the test any time. An AMH score between 6 and 24 pmol/l shows a normal reserve. A reading between 24 and 70 is on the high side, suggesting PCOS. Above 70, you’re in the danger zone of severe PCOS and a high risk of hyperstimulation in a stimulated IVF cycle using your own eggs. Look up OHSS: you don’t want to go there. At the lower end, a score below 3 is negligible.

So your AMH test lets you and your doctor make an informed choice on whether or not to go ahead. A reasonably high, rather than a reasonably low, AMH score is generally best. More follicles usually lead to more collected eggs after IVF stimulation. If there are more eggs to fertilise, there may be a better selection of embryos to transfer.

This is backed up by research on anti-Müllerian hormone and assisted reproduction from The Endocrine Society. It found a significantly better birth rate among IVF patients with higher AMH levels than those with low levels. People with a higher AMH concentration were more than twice as likely to give birth. Interestingly, the study concluded that high AMH levels may be linked to quality, and not just quantity, of eggs. In essence, eggs from high-AMH women were deemed more capable of going all the way.

AMH continues to intrigue clinicians, and studies are ongoing into its role in ovarian function. IVF patients should take an AMH test. But be warned: it’s often marketed as a specialist fertility test and can cost more than the other blood-hormone tests put together. If you’re a UK citizen, your GP won’t even consider paying for it.

39 comments

farahnaz

My serum AMH level is 0.413 and FSH is 4.08.i am 39.is there any chance to have IVF successfully?
please help me.

I go several times under Letrozol,Clomiphen and Laparoscopical cauterization of cysts(as I was pt of PCOS.Now I am 34+years old and my amh value is 1.67 ng/ml.Please,tell me if I go for IVF will be that fruitful for me?

Hi,I’m 39, and my AMH level is 0.42 I try for ivf.
please suggest this level is good .Should i used my egg or donner

January 09, 2018

Grace

Yes, over 1 is good.

January 26, 2018

R

I’m a 37 year old now single women in good health. However I went for a fertility mot and found out I have an age related AMH of 1.6. And five eggs on the scan (apparently there should be 10). I’m very upset but also confused. I’ve been told I need to take Clomid but can’t understand why I would do that if I’m expected to have a poor response? Also is there any way to raise AMH levels ? Thanks in advance

Hi I just got my hormone levels checked and my FSH was borderline normal and my AMH was 7.9. Does that mean that I automatically have to go through IVF and is there any way to get my AMH level to a normal range to naturally? Also, are there any other methods/ways that I can conceive either naturally or with minimal pricing such as clomid etc? If I do need IVF what type of IVF/cost will I be looking at.

I m 24 with increased AMH level and also increase in LH level .
AMH-15.13
LH -32.34
What to know about worry point and treatments to conceive a baby ..
Tell me what is my status of getting pregnent. ..so that i can prepare my self for what ever god has planed for me …..

Hi,
I have just been told that my AMH level is 1.6 which means I am not eligible for Funded IVF. I’m devistated as I desperately want a child. I’m 39 and wondered if anyone else is or has been in this position and if there is any advise? Thank you

I have an amh of 1.9. Also taking DHEA as hear it increases AMH (not sure how) and egg quality. Good luck!

June 04, 2017

Sumi

My amh level is 1.7 is it hopful for ivf and iui

January 24, 2018

Positive parenting

Hi,
If you have a low AmH don’t be disheartened.
There is something you can do to help.
I’m now on my 3rd IVF cycle and on the first cycle 12 months ago the consultant said I just made treatment as I had a low AMH of 3.6 and I was 40
I asked could it be highered he said no. Sadly that cycle failed after getting just 3 eggs and I was on a short protocol.
After lots of research I read up on a supplement called DHEA that is being used by some IVF clinics stateside to raise AMH levels. They recommend a course of three months. I did and three months later it ha raised to 7! I continued and within another two months it had raised to 9.3! this time at a new ivf centre I did the long protocol with buserelin and menopur and got a whopping 11 eggs!
i think it’s definitely worth looking into.

Hi,
I have just seen your post.
I was today told that my AMH level is 1.6 and that I’m not eligible for funded IVF due to my age 39 and my AMH. Do you have any advise?
It’s not about the money as I will pay anything to have a baby

Thank you
Kelly

May 15, 2017

Carrie

Hi , just read your message. I have the same AMH as you do , and I desperately want my first baby. Where can I get the supplements that you mentioned please ?

January 09, 2018

Abir

Are you sure DHEA increase the level of AMH

March 04, 2018

gomathi

my amh is 1.0, right tube blocked, left tube at risk of ectopic pregnancy . my last resort to conceive is with ivf .. i am very anxious

Hello, I am 35, turning 36 in April, and I have borderline low AMH, normal FSH, and above normal high Prolactin in the blood. I do intensive exercise 4-5 hours a week. I also had polyps and from a recent smear test there were “severe non-specific cellular changes evident”. I have never been trying to conceive but I am somewhat concerned about potential fertility issues due to age and a few of the said complications. I also question if I could be a good candidate for ivf if natural conception is not possible. Alternatively, whether oocytes preservation could be a solution for fertility preservation.

I’m 42 and have triple x chromosome. Had one healthy pregnancy in my 20’s and live birth but sadly lost baby at 19 months. Following this I experience 11 miscarriages and one ectopic. AMH level is 3.2 and partner tests all normal. been trying for 5 years no success. IVF consultant suggests I could have a live birth with the help of IVF.
Notes above on this site state that this is not possible for women with low AMH levels.

Can anyone tell me what are the real chances of a successful pregnancy and live birth for me using my own eggs?

Just about to start 3rd atemp of ivf this time egg sharing! Looking forward to potentially helping another couple 🙂 I have an amh level of 36 so it’s quite high I usually have about 20 eggs collected so plenty to share around 🙂 fingers crossed it’s 3rd time lucky

am not sure if you can answer my question or not but i’ll give it a shot!
I am 29. My fsh has been 10.1 and most recently 9.7. My amh is 3.97 my afc is 15+ on one ovary and 8-9 on the other.my estradiol level was 45
my prolactin was 10.9
my LH was 11.1

My husband and I unsuccessfully tried for a year to inseminate ourselves due to his inability to ejaculate during intercourse. Our first IUI in march was successful, however it ended at 10 weeks with a d&c due to a blighted ovum.
I have done 3 unmedicated iuis and one with clomid after my miscarriage and they were all unsuccessful. I believe that most were bad timing. Can you tell me if I move to IVF, if my borderline FSH will be troublesome? I used to smoke when I was younger, about 6 cigarettes per day. The past few years, I smoked maybe one per day until the past few months when I quit. Do you think that could be the cause of my fsh being high and possibly indicating that I have poor quality eggs even though I have a lot? My husband and I are looking into ivf in January if our next 2 iuis are unsuccessful. I read research all day about high fsh and good amh but I just don’t understand why it happens and if it’s possible for all of my eggs to be of bad quality

Thanks for your comment. We’re sorry to hear of the difficulties you’ve been having. The clinic will advise on this. If you’d like to complete a medical questionnaire, do email us via the contact page.